Oh good grief. The document you linked to like it's a big "gotcha" is a press release for a talk - "Setting fair regulations for top female athletes that have naturally higher testosterone levels" - given in May 2019 in the wake of the CAS decision in the Caster Semenya case.
Although the talk is billed as being about testosterone levels in "top female athletes" and "women," in fact it's about testosterone levels in athletes of both sexes who compete and have competed in in the female category. Including XY DSD athletes like Semenya who have so-called "high natural testosterone" because they have a set of fully-developed testes in good working order which pump out the massive amounts of testosterone customary for males and put their natural serum T levels squarely in the in the normal male range.
The talk, and the work it's based, are both flawed and misleading because they lump together two very different groups:
1) XY male athletes in women's sports who have male-only DSDs like Semenya and Dutee Chand and testes that produve T in the normal male range
and
2) XX female athletes whose natural T is slightly or moderately elevated above the top end of the normal female range because they have a female-only health condition involving their ovaries, polycystic ovary syndrome or PCOS.
The main focus of the talk was the IAAF/WA regulations that Semenya challenged in court and the CAS decided to greenlight when deciding against Semenya in the landmark decision it handed down in on May 19, 2019. Those regulations require(d) XY DSD athletes to reduce their testosterone to below 5 nmol/L in order to compete in middle distance women's track & field events.
The 2019 regualtions have since been extended to all women's events. What's more, now XY DSD athletes have to reduce their T to an even lower level - 2.5 nmol/L - and for a longer period of time to gain eligibility for women's compeition.
The document you linked to is full of the sort of dishonest framing and misleading language that the gender vendor industry constantly uses to try to sow confusion and obscure the truth in an attempt to make to make it appear that there's hardly any difference between female athletes with hyperandrogenism due to PCOS and male DSD athletes with normal levels of T for males.
The new IAAF regulations require women with testosterone levels in the male range to medically reduce them to be allowed to compete, however the fairness and morality of these rules have been challenged by human rights and academic experts.
The reasons for high testosterone levels in women are complex and may be caused by rare conditions such as having the male Y chromosome and male gonads.
Prof Angelica Lindén Hirschberg from the Karolinska Institutet and Karolinska University hospital in Sweden and colleagues, have investigated the levels of testosterone in female athletes and...found that top female athletes were more likely to have common and mild conditions that increase testosterone levels, like polycystic ovary syndrome (PCOS) but also rare conditions with very high naturally occurring levels of testosterone in the male range.
[The "rare conditions" referrred to in that passage are male genetics and testes.]
women with polycystic ovary syndrome (PCOS) are overrepresented in elite athletes. PCOS, which is a mild form of hyperandrogenism...
The prevalence of differences of sex development (DSD) is also increased among female athletes. XYDSD may cause a greatly increased production of testosterone in the male range, i.e. 10-20 times higher than in the normal female range.
If the [XY DSD] individual has normal androgen sensitivity, her muscle mass will develop as in males, along with increasing signs of virilization.